Abstract

Objectives Despite growing recognition of the importance of staff perceptions of safety culture to the quality of care provided to patients,
there is limited published work describing the safety culture within hospital pharmacy practice. The aim of this study was
to investigate the patient safety culture within the pharmacy service across a group of publically funded hospitals.

Method An anonymous safety-culture assessment tool was made available to all pharmacy staff, measuring respondents' level of agreement
with 43 statements relating to seven principle safety ‘domains’. Responses were recorded using a five-point Likert scale and
reported using percentage-positive agreement and Bayes factor (BF) analysis.

Results Based on a response rate of 51% (n=99/195), pharmacy staff report a very strong positive safety culture profile for ‘Investigating
and learning from incidents’ and ‘Perceptions of the causes of incidents/reporting’ (99.9%, BF>1000(decisive), for both).
However, there was decisive evidence toward negative Likert responses for the domains ‘Staffing and management’ (99.9%, BF>1000
(decisive)) and ‘Team working’ (99.3%, BF=132 (decisive)). Significant differences also emerged in favour of smaller hospitals
for ‘Teamwork’ (96.2%, BF=26 (very strong)), clinical pharmacists (n=51) versus technicians (n=21) for ‘Perceptions of the
causes of incidents/reporting’, ‘Teamwork’ and ‘Commitment to patient safety and education’ (99.9%, BF>1000 (decisive), for
all). Also for pharmacists affiliated with a professional association (n=54) compared with all staff without an affiliation
(n=43) (99.9%, BF>1000 (decisive)).

Conclusions Our findings identify important influences on the patient safety culture of hospital pharmacy, including the role of hospital
type, pharmacy staff group and membership with professional-advocacy groups. A better understanding of the factors which drive
these differences is necessary for pharmacy services to better embrace safety improvement initiatives.